Question

A sexually active 25 year old male comes to the clinic with a chief complaint of testicular pain. What are the differential diagnoses? How would you go about finding your diagnosis? What are the treatment options for each diagnosis?

Answer 1

Testicular pain is pain that occurs in or around one or both testicles. The pain usually originates from the groin or abdomen and is felt in one or both sides of the testicles.

TESTICULAR TORSION: Male has 2 testicles that rest inside the scrotum. A cord known as the spermatic cord that carries blood to the testicles. It is more commonly seen in adults. Pain in the testicular is a common cause of this diagnosis. It can be confirmed by conducting a) Urine culture b) urinalysis c) an ultrsound and d) through examination of secretions from the prostate. It can be treated by providing antibiotics, a surgery to untwist the testicles, surgery to reduce fluid accumulation in the testicles, and through pain medications. The pain in the testicles can be prevented by practicing safe sex, including using a condom, during intercourse.

ORCHITIS: is an inflammation of the testicles can be caused by either bacteria or virus. The primary symptoms of orchitis is pain in the testicles and groin. This disease can be tested through an urine sample (to determine any reason for STIs or other infections) and ultrasound. Antibiotics is the main option for bacterial orchitis along with anti-inflammatory medications and cold packs. Practicing safe sex can prevent bacterial orchitis.

EPIDIDYMITIS: It is also an inflammation of the epididymis (a tube located at the back of the testicles) When this tube swollen it cause pain and swelling to the testicles. It can affect men for all ages especially 14 and 35. IT is usually caused by a bacterial infection or by STD. It can be diagnosed through rectal examination ( show causes of an enlarged prostate), CBC- complete blood count to find out any infection, Urine sample to rule out STIs. It can be treated by administering antibiotics, pain and anti-inflammatory medications and through bed rest.